The metabolic syndrome is an enormous public health problem because of its association with premature vascular disease. Our proposed SCCOR will define the mechanisms that link obesity, insulin resistance, the metabolic syndrome and atherosclerotic vascular disease. This information will be translated to the clinic to improve the care of people with the metabolic syndrome. One key component of the seamless transfer of new knowledge from bench to bedside is the confirmation in human tissues of critical observations made in animal models and cell systems. Building on a long history of research interactions between academic vascular surgeons and other investigators at Washington University, the Vascular Surgery and Histopathology Core Unit will leverage the established skills and tissue procurement infrastructure of the Section of Vascular Surgery to provide unique resources to this SCCOR in Vascular Injury, Repair, and Remodeling. The centralization of services within this core will provide effective and efficient utilization of valuable clinical resources and quality control that otherwise could not be achieved by individual Research Projects alone. The purposes of the Vascular Surgery and Histopathology Core (Core Unit C) are: (1) to recruit subjects for clinical research projects requiring patients with clinically-evident peripheral vascular disease; (2) to maintain a centralized database of clinical information pertinent to the metabolic syndrome for participating patients with vascular disease in order to facilitate correlations between clinical data and blood and tissue specimens; (3) to assist in the procurement, handling, maintenance and distribution of specimens from participating patients including blood and surgical tissue specimens;and (4) to perform histopathological staining and evaluation of blood vessel specimens obtained during surgical procedures and experimental studies. This Core Unit has the potential to help transform the care of people with metabolic syndrome by providing translational services to validate the clinical relevance of novel mechanisms contributing to vascular disease.